Preoperative platelet lymphocyte ratio (PLR) is superior to neutrophil lymphocyte ratio (NLR) as a predictive factor in patients with esophageal squamous cell carcinoma

World Journal of Surgical Oncology

Qi-Xun Chen¹  Ying Huang²  Ji-Feng Feng¹ 

[1] Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou 310022, Zhejiang province, China;Department of Nursing, Zhejiang Cancer Hospital, Hangzhou, China

关键词: Survival;    Squamous cell carcinoma;    Prognostic factor;    Platelet lymphocyte ratio;    Neutrophil lymphocyte ratio;    Esophageal cancer;   

Others  :  820237
DOI  :  10.1186/1477-7819-12-58

 received in 2013-07-12, accepted in 2014-03-03,  发布年份 2014

【 摘 要 】

Background

Recent studies have shown that the presence of systemic inflammation correlates with poor survival in various cancers. The aim of this study was to determinate the prognostic value of the neutrophil lymphocyte ratio (NLR) and the platelet lymphocyte ratio (PLR) in patients with esophageal squamous cell carcinoma (ESCC).

Methods

Preoperative NLR and PLR were evaluated in 483 patients undergoing esophagectomy for ESCC from January 2005 to December 2008. The prognostic significance of both markers was then determined by both uni- and multivariate analytical methods. Receiver operating characteristic (ROC) curves were also plotted to verify the accuracy of NLR and PLR for survival prediction.

Results

High preoperative NLR (≥3.5 versus < 3.5, P = 0.039) and PLR (≥150 versus < 150, P < 0.001) were significantly associated with poor overall survival in multivariate analysis. However, our study demonstrated a better discrimination for the PLR in terms of hazard ratio(HR) than the NLR (HR = 1.840 versus HR = 1.339). Patients with NLR ≥3.5 had significantly poorer overall survival compared to NLR <3.5 (35.4% versus 57.7%, P < 0.001). Patients with PLR ≥150 also had significantly poorer overall survival compared to patients with PLR <150 (32.7% versus 63.5%, P < 0.001). The area under the curve (AUC) was 0.658 (95% confidence interval (CI): 0.610 to 0.706, P < 0.001) for NLR and 0.708 (95% CI: 0.662 to 0.754, P < 0.001) for PLR, indicating that PLR was superior to NLR as a predictive factor in ESCC.

Conclusions

Preoperative NLR and PLR were significant predictors of overall survival in patients with ESCC. However, PLR is superior to NLR as a predictive factor in patients with ESCC.

【 授权许可】

   
2014 Feng et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Zhao P, Dai M, Chen W, Li N: Cancer trends in China. Jpn J ClinOncol 2010, 40:281-285.
• [2]Wijnhoven BP, Tran KT, Esterman A, Watson DI, Tilanus HW: An evaluation of prognostic factors and tumor staging of resected carcinoma of the esophagus. Ann Surg 2007, 245:717-725.
• [3]Feng JF, Chen QX: Prognostic significance of preoperative CA72-4 in patients with esophageal squamous cell carcinoma. Arch Iran Med 2013, 16:338-342.
• [4]Tachibana M, Kinugasa S, Hirahara N, Yoshimura H: Lymph node classification of esophageal squamous cell carcinoma and adenocarcinoma. Eur J CardiothoracSurg 2008, 34:427-431.
• [5]Feng JF, Huang Y, Zhao Q: Tumor length in elderly patients with esophageal squamous cell carcinoma: is it a prognostic factor? Ups J Med Sci 2013, 118:145-152.
• [6]Feng JF, Zhao Q, Chen QX: Prognostic value of subcarinal lymph node metastasis in patients with esophageal squamous cell carcinoma. Asian Pac J Cancer Prev 2013, 14:3183-3186.
• [7]Mantovani A, Allavena P, Sica A, Balkwill F: Cancer-related inflammation. Nature 2008, 454:436-444.
• [8]Balkwill F, Mantovani A: Inflammation and cancer: back to Virchow? Lancet 2001, 357:539-545.
• [9]Roxburgh CS, McMillan DC: Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol 2010, 6:149-163.
• [10]Sato H, Tsubosa Y, Kawano T: Correlation between the pretherapeutic neutrophil to lymphocyte ratio and the pathologic response to neoadjuvant chemotherapy in patients with advanced esophageal cancer. World J Surg 2012, 36:617-622.
• [11]Sharaiha RZ, Halazun KJ, Mirza F, Port JL, Lee PC, Neugut AI, Altorki NK, Abrams JA: Elevated preoperative neutrophil:lymphocyte ratio as a predictor of postoperative disease recurrence in esophageal cancer. Ann SurgOncol 2011, 18:3362-3369.
• [12]Corley DA, Buffler PA: Oesophageal and gastric cardia adenocarcinomas: analysis of regional variation using the Cancer Incidence in Five Continents database. Int J Epidemiol 2001, 30:1415-1425.
• [13]Rashid F, Waraich N, Bhatti I, Saha S, Khan RN, Ahmed J, Leeder PC, Larvin M, Iftikhar SY: A pre-operative elevated neutrophil: lymphocyte ratio does not predict survival from oesophageal cancer resection. World J SurgOncol 2010, 8:1.
• [14]Bhatti I, Peacock O, Lloyd G, Larvin M, Hall RI: Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio. Am J Surg 2010, 200:197-203.
• [15]Kusumanto YH, Dam WA, Hospers GA, Meijer C, Mulder NH: Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor. Angiogenesis 2003, 6:283-287.
• [16]Klinger MH, Jelkmann W: Role of blood platelets in infection and inflammation. J Interferon Cytokine Res 2002, 22:913-922.
• [17]Dutta S, Crumley AB, Fullarton GM, Horgan PG, McMillan DC: Comparison of the prognostic value of tumour- and patient-related factors in patients undergoing potentially curative resection of oesophageal cancer. World J Surg 2011, 35:1861-1866.